In this article, an updated overview of meningitis and encephalitis in infants and children is presented. Meningitis, bacterial meningitis in children, journal neurology, neurosurgery and psychiatry, emergency medicine international, international journal of research in medical sciences,infectious diseases journals. Although the pathogenesis of bacterial meningitis is not completely understood, knowledge of bacterial invasion and entry into the cns is improving. Acute bacterial meningitis in adults sciencedirect. Summary clinical practice guidelines for the acute management of infants and children with. The replacement of pcv7 with pcv, which covers serotypes 7f and 19a, led to a rapid reduction in ipd, including meningitis, caused by these serotypes across all age groups. Addendum for meningitis april 01, 2016 download pdf. Diagnosis and management of bacterial meningitis in the paediatric. Most children with viral meningitis recover on their own without treatment.
If the infection or resulting inflammation progresses past the membranes of the brain or the spinal cord, then the process is called encephalitis inflammation of the brain. Outbreaks affecting older children and adults occur in this region, even after. Seehusen, md, mph, eisenhower army medical center, fort gordon, georgia. Infections of the meninges meningitis and the brain. Meningitis symptoms in children meningitis research. Meningococcal meningitis affects people of all ages and tends to occur in epidemics, especially among those who live in crowded conditions. Meningitis is most often caused by a bacterial or viral infection that moves into the cerebral spinal fluid csf. Signs and symptoms of meningeal inflammation have been recorded in countless. Etiology the etiology and incidence of bacterial meningitis are closely related to age and whether the infants have received routine immunization with the haemophilus influenzae type b conjugate vaccine and the streptococcus pneumoniae conjugate vaccine. In general, meningitis due to bacteria bacterial meningitis is more severe than meningitis caused by viruses viral meningitis. For viral meningitis, including in infants and children, see viral meningitis. Meningitis can be caused by many different pathogens including viruses and fungi but the highest global burden is seen with bacterial meningitis. The most common causes have been streptococcus pneumoniae, neisseria meningitidis, haemophilus influenzae type b hib, group b streptococcus gbs, and listeria monocytogenes table 1. Management of central nervous system infection in children slcog.
In the past, hib was the most common cause of meningitis in children under five years of age. These guidelines are aimed at achieving the best possible paediatric care for children with cns infection within sri. Over the past several decades, the incidence of bacterial meningitis in children has decreased but there remains a significant burden of disease in adults, with a mortality of up to 30%. It is important to note that routine childhood immunization has significantly decreased. The peak incidence of tbm occurs in younger children who are less than five years of age, and most children present with latestage disease. Normally, meningitis causes fever, lethargy, and a decreased mental status problems thinking, but these symptoms are often hard to detect in young children. Meningitis in children symptoms, warning signs, treatment. Carriage of the bacteria is completely harmless most of the time. Viral meningitis is more common, but it is less serious than bacterial meningitis. Meningitis is a swelling inflammation of the thin membranes that cover the brain and the spinal cord. What signs and symptoms distinguish meningitis from. Meningococcal meningitis affects people of all ages and tends to occur in epidemics, especially among those who live.
Risk for travelers is highest in people visiting meningitis belt countries who have prolonged contact with local populations during an epidemic. Effect of pneumococcal conjugate vaccines on pneumococcal. Most children will make a full recovery after meningitis, but it can take time. In a small number of cases, bacterial meningitis can cause death. Limb pain, pale skin, and cold hands and feet often appear earlier than the rash, neck stiffness, dislike of bright lights and confusion. However the main impediment to the accurate diagnosis of active tb is the paucibacillary nature of the disease in children. The second most common bacterial cause of meningitis is neisseria meningitidis meningococcus. The puzzling late discovery of meningitis as a clinical entity did not delay a futiher rapid development of knowledge. Consequently, meningitis develops most commonly as a complication of progressive primary infection in infants and young children and from chronic reactivation bacillemia in older adults with immune deficiency caused by aging, alcoholism, malnutrition, malignancy, human immunodeficiency virus hiv infection, or drugs eg, tumor necrosis factor.
Meningitis diagnostics use cases world health organization. Initial history and physical examination in infants and young children with fever is directed at recognition. Organisms causing meningitis in childhood, and the currently appropriate. Many people, including approximately half of preschool children 1, carry pneumococcal bacteria in the back of their nose and throat, and constantly pass them around by coughing and sneezing and close contact. This book is distributed under the terms of the creative commons. Meningitis is a devastating disease and remains a major public health challenge. This book aims to provide general practitioners, paediatricians, and specialist physicians with an essential text written in an accessible language, and also to highlight the differences in pathogenesis and causative agents of menin.
Children who have not been given routine vaccines are at increased risk of developing certain types of bacterial meningitis. Young children and adults over 65 are at the greatest risk. Bacterial meningitis in infants over 3 months of age. Meningitis in children what is meningitis in children. Corrected gestational age meningitis is more common, but it is less serious than bacterial meningitis. Tb can mimic many common childhood diseases, including pneumonia, generalised bacterial and viral infections, malnutrition and hiv.
Cryptococcal meningitis is a common fungal form of the disease that affects people with immune deficiencies, such. Because these diseases can occur suddenly and progress rapidly, anyone who is suspected of having either meningitis or encephalitis should immediately contact a. Pdf meningitis and encephalitis in infants and children. The leading cause of bacterial meningitis is the illnamed bacterium haemophilus influenzae b hib, originally thought to be an influenza virus.
Most children with viral meningitis recover completely. For suspected bacterial meningitis in children 6 weeks old, consider. Is the classic triad of fever, headache, and stiff neck reliable for bacterial meningitis. Before routine use of pneumococcal conjugate vaccine, children younger than 1 year had the highest rates of pneumococcal meningitis, approximately 10 cases per 100,000 population. Most common bacterial causes of meningitis in the united states are. A long course one year of medications is recommended for children who develop tb meningitis. The signs and symptoms of meningitis can be different depending on the age of your child, and whether the disease is caused by a virus or bacteria. Central nervous system infections guidelines on meningitis introduction these guidelines are aimed at achieving the best possible paediatric care for children with cns infection within sri lanka. Meningitis is a medical emergency requiring a rapid diagnosis and an immediate transfer to an institution supplied with appropriate antibiotic and supportive measures. Differential diagnosis between viral and bacterial meningitis in children. It should be utilized together with the clinical input and.
The pathogenesis, epidemiology, clinical features and diagnosis of acute bacterial meningitis and the treatment and prognosis of bacterial meningitis in neonates meningitis is a very serious condition. Most pathogenic microbes could potentially cause meningitis in the human brain. Bacterial meningitis in children what you need to know. Although the occurrence of tuberculous meningitis tbm in children is relatively rare, but it is associated with higher rates of mortality and severe morbidity. The incidence of pneumococcal meningitis in the united states. The pocket book is for use by doctors, nurses and other health workers n who are responsible for the care of young children at the. This second edition is based on evidence from several who updated and published clinical guidelines. The clinical symptoms and signs of bacterial meningitis in children vary depending on the age of the child and duration of disease.
Darnall army medical center, fort hood, texas dean a. In particular, meningitis is a major cause of death in children under 5 years old. The presentation is similar to bacterial meningitis, except that neurologic dysfunction e. Managing meningitis epidemics in africa world health organization. Viral meningitis is the most common form of meningitis. Meningitis caused by serotype 7f has been associated with more severe disease increased complications, higher cfr in children than meningitis caused by other serotypes. In meningitis belt countries, high rates of disease are seen in people up to age 30 years, and the highest rates are in children and adolescents aged 5 14 years. Clinicians need a low threshold for suspecting meningitis, to undertake appropriate investigations and provide treatment in a timely manner, to minimise the risk of poor outcome in bacterial disease, while limiting unnecessary treatment in viral meningitis. The first symptoms are usually fever, vomiting, headache and feeling unwell. One in five children infected is left with permanent disabilities, such as deafness or cerebral palsy. An intravenous antifungal medication may be administered to the child with fungal meningitis. Immunology and vaccinepreventable diseases pink book.
437 602 62 84 187 1118 453 625 835 139 17 1416 1325 173 917 938 972 1353 185 627 1011 1098 681 831 816 102 11 569 1233 527 650 177 81 629 484 726 1305 1068 391 187 1277 1391 848 1499 430 316